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April-June 1998 Volume 40 | Issue 2
Page Nos. 101-198
Online since Friday, May 14, 2010
Accessed 10,475 times.
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EDITORIAL |
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Importance of Undergraduate Psychiatric Training |
p. 101 |
JK Trivedi PMID:21494458 |
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ARTICLES |
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The Forgotten Millions |
p. 103 |
AK Agarwal PMID:21494459Millions of chronic mentally sick are living in this country without proper care. Human rights of most of these patients both for treatment and for leading a life of dignity have been seriously abrogated. This oration discusses the extent of the problem & reviews the won\ done in this area in India and abroad. Major emphasis is to develop a programme for destigmatization of mental illness and to develop suitable models of care for chronic mentally sick keeping the realities of Indian situation in mind. The proposed programme emphasises on multi modal care of the mentally sick and involvement of local self government institutions like panchayats & municipal corporations. |
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REVIEW ARTICLES |
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Management of Schizophrenia : An Update |
p. 120 |
Parmanand Kulhara PMID:21494460Introduction of potent antipsychotics for the treatment of schizophrenia not only brought changes in the outlook for management of this disorder but also infused optimism and hope. However, substantial number of patients fail to respond to conventional antipsychotics thus creating a class of patients who are termed as treatment resistant, treatment refractory or difficult to treat patients. This update focuses on such patients and provides description of various options for their management Though atypical antipsychotics offer respite to a vast number of such difficult to treat patients, their efficacy is perhaps over-emphasised. Conversely, the potential of psychosocial therapies in such patients has not been fully exploited. Management of such patients in the community is a challenge and in taking up this gauntlet, a judicious mix of pharmacotherapy and psychosocial intervention strategies, close monitoring of the patients with a view to detect prodromes of relapse and early intervention are likely to play increasingly important part. |
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The Relevance to Meta-Analysis, Systematic Reviews and the Cochrane Collaboration to Clinical Psychiatry |
p. 135 |
Prathap Tharyan PMID:21494461Traditional review articles provide clinicians with syntheses of the medical literature but are criticised as being haphazard in their methodology and biased in their conclusions. Systematic reviews use rigorous methods to minimise bias and statistical methods to synthesise results (meta-analysis) that increase power and precision. They permit investigation of generalisability and consistency, improve transparency of methodology, and enhance reproducibility. This article examines the science of systematic reviews and meta-analysis and their relevance to clinical psychiatry. It evaluates the potential errors and sources of bias of meta-analysis, and offers guidelines for evaluation of systematic reviews. It highlights the efforts of the Cochrane Collaboration which is an international organisation involved in preparing, maintaining and
disseminating highly structured, frequently updated, and good quality systematic reviews of the effects of interventions in all aspects of health care. |
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ARTICLES |
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Prevalence of Mental and Behavioural Disorders in India : A Meta-Analysis  |
p. 149 |
Venkataswamy M Reddy, CR Chandrashekar PMID:21494462A meta-analysis of 13 psychiatric epidemiological studies consisting of 33572 persons in 6550 families yielded an estimate prevalence rate of 58.2 per thousand population. Organic psychosis (prevalence rate 0.4), schizophrenia (2.7), affective disorders (12.3) contributed a rate of 15.4 for psychoses. The prevalence rate for mental retardation (6.9), epilepsy (4.4), neurotic disorders (20.7), alcohol/drug addiction (6.9; and miscellaneous group (3.9) were estimated. Higher prevalence for urban sector, females, age group of 35-44, married/widowers/divorced, lower socioeconomic status, and nuclear family members were confirmed. Epilepsy and hysteria were found significantly high in rural communities. Manic affective psychosis, mental retardation, alcohol/ drug addiction and personality disorders were significantly high in males. The findings indicated that there are 1.5 crore people suffering from severe mental disorders (psychoses) in India, and that severe diseases have higher representation at specialized as well as general hospital clinics. Among other things, the results aid in conducting morbidity surveys by more methodological
approach. |
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Development of A Scale to Assess Attitudes Toward Drinking and Alcoholism |
p. 158 |
Debasish Basu, Anil Malhotra, Vijoy K Varma, Rama Malhotra PMID:21494463Responses from 205 subjects to a 51 -item self-report Likert scale for assessment of attitudes toward drinking and alcoholism (SAADA-I) were subjected to a principal component factor analysis with varimax rotation. The resultant 29 item modified version of the scale (SAADA-II) had four factors named "Acceptance1', "Rejection", "Avoidance" and "Social dimension", and explaining 8.59%, 8.35%, 4.76% and 3.79% of the variance respectively (total variance explained 25.49%. Measures of internal consistency and stability over time both yielded overall satisfactory results. The complex, multidimensional nature of the attitudes toward drinking and alcoholism is emphasized by this study. Also, the scale, after further modifications, may be used as a sound psychometric index for measuring such attitudes especially in the care-givers, professionals and burdensharers dealing with alcohol dependent persons. |
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Influence of Stressful Life Events and Coping Strategies in Depression |
p. 165 |
YK Satija, GB Advani, SS Nathawat PMID:21494464The influence of stressful life events and coping strategies was studied in 50 depressed and 50 non-depressed persons. It was observed that depressives experienced significantly more stressful life events and were also using significantly more avoidance coping strategies as compared to their non-depressed counterparts. The moderate and severely depressed patients were exposed to more stressful life events and were using more avoidance coping strategies as compared to mildly depressed patients. |
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Subjective Wellbeing Among Police Personnel |
p. 172 |
PR Geetha, DK Subba Krishna, SM Channabasavanna PMID:21494465To study whether high job stress has 'spill over effect' on other dimensions of life, subjective well being inventory (SWBI) and GHQ were administered to 201 policeman selected randomly from Bangalore city, India. Policemen scored significantly high in all dimensions expect in social support when compared to urban middle class men working in factories. The police who scored low in GHQ had significantly higher scores in all dimensions of SWBI except in social contact. The results indicate that various dimensions of SWB of police are not affected. Psychosocial and job related factors buffering job stress have to be studied and further strengthened. |
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Neurological Soft Signs, Cognitive Dysfunction and Ventricular Brain Ration in Schizophrenics |
p. 180 |
Narottam Lal, SC Tiwari, Shrikant Srivastava, Abdul Khalid, Siddhartha , Neera Kohli PMID:21494466An association between cognitive dysfunction, neurological soft signs, enlarged brain ventricles and widened cortical sulci has been reported in schizophrenia. The present work aimed to study the relevance of positive and negative dichotomy with relation to neuropsychological performance of the schizophrenic patients, and the presence of neurological soft signs. In 23 schizophrenics patients diagnosed according to DSM-III-R of which 14 were of positive subtype and 9 were of negative subtype. At least one neurological soft sign was present in all the patients. The positive group had higher WMS and IQ scores and lower BGT scores than the negative group. Negative, correlation was seen for WMS and BGT scores with Ventricular Brain Ratio (VBR), and the.' soft signs showed positive correlation in the positive subtype only. |
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Trans-Sexualism in Schizophrenia : A Case Report |
p. 186 |
RC Jiloha, JC Bathla, A Bawbja, V Gupta PMID:21494467A 19 year old female schizophrenic had a delusion that she was a male and behaved and dressed like a male. She developed intimacy with another girl to marry her. The patient responded to effective treatment of schizophrenia. Further implication have been discussed. |
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Dandy-Walker Syndrome with Epilepsy and Psychosis : An Atypical Presentation |
p. 189 |
SC Pradhan, Jnanamay Das, Vinod Kumar Sinha PMID:21494468A case of "Dandy-Walker Syndrome' with secondary Generalised tonic clonic seizures and post-ictal psychosis is reported in a 33 year old man. The venthculo-pehtoneal shunt procedure, carried on 3 years back has failed to bring down the seizure frequency. Electrophysiological and neuropsychological investigation suggest impairment in left temporal lobe. |
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Mania Associated with Hepatitis B : A Case Report |
p. 192 |
Ramanand Satapathy, Prakash M Jai Babu, V Padma, Vijay M Gopal PMID:21494469Mania following or associated with medical and pharmacological conditions is well known. However there are no reports of mania in a case of acute viral hepatitis B infection. This paper describes a manic disorder in a young female with acute viral hepatitis B infection, without any past or family history of psychiatric illness or associated psychosocial stressors. |
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LETTERS TO THE EDITOR |
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Haloperidol Decanoate : Route of Administration |
p. 195 |
Chittaranjan Andrade PMID:21494470 |
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Stress, Depression and Genomic Change |
p. 195 |
JS Srivastava, Rajul Tandon PMID:21494471 |
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Treatment by Imipramine of Deafness and Depression |
p. 196 |
VK Srivastava PMID:21494472 |
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BOOK REVIEWS |
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Behavioural and Social Research on Injection Drug Abuse and HIV Prevention |
p. 197 |
AN Chowdhury |
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Schizophrenia : The Indian Scene |
p. 198 |
R Thara |
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